Corneas come in many shapes and sizes. Some so extreme that even standard gas permeable or custom soft lenses can’t correct every patient’s vision. That’s why scleral contact lenses should be a part of any specialty contact lens practice. The iSight™ CXL Scleral contact lens from GP Specialists is designed for those extreme irregular cornea cases.
iSight™ CXL Scleral contact lenses are a uniquely designed scleral lens that utilizes multiple aspheric conical curves to achieve a more natural tangential fitting zone. This unique design means that the iSight™ CXL Scleral contact lens has the ability to vault both the cornea and limbus zone while maintaining a minimal sagittal depth that promotes good tear exchange.
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We recommend two methods to establish the initial Base Curve to select.
Center Distance design. Because we recognize that not all designs work on all patients, we have included both in the iSight™ CXL Scleral fitting set. The fitting set includes 3 base curves in both the Center Near & Center Distance design. The iSight™ CXL Scleral Multifocal is also a progressive design incorporating Distance /Intermediate/near vision or Near/Intermediate/Distance. The same parameters that are available in our spherical iSight Scleral contact lens design are also available in our multifocal scleral lens design.
10 Spherical scleral fitting lenses
3 Center Near Multifocal scleral fitting lenses
3 Center Distance Multifocal scleral fitting lenses
Trial set sagittal depth chart
Inserting iSight™ CXL Scleral Contact Lens Using A DMV® Scleral Cup™
Use a special device, called a DMV® Scleral Cup™ to support the lens for application. The application process with the DMV Scleral Cup starts by lightly squeezing the tapered handle so you create a mild suction. Carefully place the scleral lens on the top of the DMV, making sure it is centered. When the lens is centered on the DMV, stop squeezing the device. This will create a mild suction and the scleral lens should be securely positioned on the DMV Scleral Cup. Completely fill the bowl of the scleral lens with a preservative free saline and add fluorescein if desired for evaluation. Position the patient’s head parallel with the countertop, or table, and have the patient look straight down. To apply the scleral lens, you will need to separate the patient’s eyelids in order to position the sclera lens on the eye. This can be accomplished by using your free hand to pull up the upper lid while having the patient pull the bottom lid down.
Slowly move the sclera lens toward the eye and instruct the patient to look directly at the black dot formed by the hole in the DMV Scleral Cup. Gently apply the lens directly on the eye and over the pupil. Once the sclera contact lens is on the eye, a light squeeze of the tapered handle will release the sclera lens from the DMV Scleral Cup. Release the lids and have the patient blink several times to clear the excess fluid. The lens will automatically center. Wash the DMV Scleral Cup frequently in warm soapy water and let air dry.
Because of the capillary forces associated with large diameter lenses, it is important NOT to attempt to remove a scleral lens by pulling from the center. This can create negative pressure making it difficult to remove the lens.
Removing the iSight™ CXL Scleral Lens With The DMV© 45™
The DMV 45 is an excellent tool to remove scleral lenses for both practitioner and patient. The DMV 45 has a 45-degree angle which keeps the fingers out of the line of sight while removing the scleral lens.
Pull the lower lid away from the cornea to expose the lower edge of the lens. Hold the handle of the DMV 45 and carefully place the device on the lower edge of the scleral lens. Once the DMV 45 is adhered to the scleral lens, gently pull the lens away from the eye. If the lens is difficult to remove, apply gentle pressure to the scleral to release the capillary pressure.
With the lens resting on the DMV 45, gently move the sclera lens off the device using your thumb and index finger.
Fitting iSight™ CXL Scleral contact lenses will add another dimension to your practice. The learning curve is not steep and can be mastered with just one or two patients. Our consultants stand ready to assist you in any way we can to make your experience a memorable one for both you and your patient.